Lenses for the smallest of eyes

Posted on 30th April 2014

Many of my patients will know contact lenses are a passion of mine. Most of my patients have straightforward prescriptions with some requiring more specialist products. However a small number of our patients are a little more complex still.

We are fortunate to work closely with the Princess Alexandra Eye Pavilion and St John’s Hospital, taking referrals from them to provide specialist expertise in dealing with even the youngest of patients including newborns with congenital cataracts.

Babies who are born with cataracts (the clouding of the eye’s lens) are usually operated on within the first few weeks of their lives. For adults, following surgery the normal course is to be fitted with lens implants or where this isn’t possible they can wear high prescription glasses (around +15.00 or so)

Babies are different. After surgery to remove the cloudy lens they have been born with the eye is usually too small to support an implant until they are at least 2 years old. They can’t be expected to wear glasses as the prescription is as high at +35.00 and changes every few weeks as it reduces towards the usual +15.00 over the first year of life.

In fact a new study has found that wearing contact lenses for a few years before having implants fitted also gives better eventual outcomes. This is an area myself and my colleagues have a lot of experience in and it is encouraging to see further study supporting the treatment. For surgeons to get the prescription spot on for a small baby is very difficult. It is hard to judge the focusing power of the baby and the infant years are a period of rapid growth so the chance of the surgeon getting their lenses as near perfection as possible increases as the baby becomes a toddler. At this time testing is far more straightforward. The eyes have developed substantially and the child’s ability to communicate makes it easier to select the right permanent lens.

As you can imagine, it isn’t easy getting a baby to wear contact lenses, perhaps even harder a toddler, but like anything, they do get used to it and as this research reiterates, the long-term benefits are worth the short-term angst.

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